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The Trump administration's health policy moves are facing a House controlled by Nancy Pelosi and the Democrats. Now is the time to try Inside Health Policy.

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Top Story

Food safety advocates say that the month-long partial government shutdown could have long-term negative effects on the morale of FDA’s food inspection staff, as well as FDA’s ability to retain and hire personnel, who might be turned off by the prospect of being furloughed.

Arizona is the eighth state to receive permission from the Trump administration to add work requirements to its Medicaid program, and after months of behind-the-scenes negotiations between state officials and CMS lawyers, CMS allowed the state to exempt some Native Americans from the requirements.

CMS on Friday (Jan. 18) announced a nation-wide expansion and several new features of its Value-Based Insurance Design model, which provides flexibility to Medicare Advantage plans with the goal of encouraging beneficiaries to consume high-value clinical services.

House Energy & Commerce Chair Frank Pallone (D-NJ) says his committee will be looking into the Medicaid work requirement waivers, which the Trump administration has approved for eight states, but E&C oversight subcommittee Chair Diana DeGette (D-CO) says they aren’t at the top of her agenda.

Federal Medicare advisers grappled Thursday (Jan. 17) with how CMS could better track opioid use in hospitals and encourage non-opioid alternatives, and it must report to Congress on those issues by March due to a mandate in last year’s landmark opioid bill.

The 2020 Notice of Benefit and Payment Parameters, the crucial rule that will set the requirements for next year’s Affordable Care Act marketplaces, cleared the review at the White House Office of Management and Budget on Wednesday (Jan. 16) and could be published soon.

The number of Arkansas Medicaid beneficiaries who lost coverage as a result of the state’s newly enacted work requirements grew to more than 18,000 last month, according to data released by the state Tuesday (Jan. 15).

The White House Office of Budget and Management’s review of CMS’ tweaked home health pre-claims review demonstration, now called the Review Choice Demonstration for Home Health Services, has seemingly stalled since CMS submitted it to OMB for review, leaving Illinois providers preparing for a demonstration with an uncertain start date.

Health Reform Debate

CMS on Thursday (Jan. 17) released its long-awaited exchange policy regulation, and while it avoided making changes to the silver-loading process, the agency did propose several other policies including allowing mid-year drug formulary changes, creating a new special enrollment period for people newly eligible for subsidies, increasing maximum out-of-pocket spending limits, and reducing the user fee by half of a percentage point.

FDA News

In an effort to encourage drug companies to develop over-the-counter (OTC) versions of overdose-reversal drug naloxone, FDA has developed a model drug facts label with pictograms that show how to use the drug, which can help consumers better understand how to use naloxone without the supervision of a health care professional, agency chief Scott Gottlieb announced on Thursday (Jan. 17).